Background

Global COVID-19 outbreak has been such a stressful experience for most of the people. Using a web-based cross-sectional study, we aimed to evaluate the acute stress response, depression, and anxiety in patients with diabetes mellitus (DM) during the COVID-19 pandemic, and to examine the effect of these psychiatric problems on diet habits and glycemic controls of patients.

Methods

This web-based survey of COVID-19 was sent to the patients through the Whatsapp platform. All participants reported their demographic data, diabetes-related information, changes in self-monitoring blood glucose measurements, physical parameters, and eating habits after COVID-19, then completed Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale, Revised (IES-R) questionnaires which assessed acute stress sypmtoms, anxiety, and depression.

Results

Three hundred and four patients with DM [(141 type 1 DM (T1D) and 163 type 2 (T2D)] were included in the study. In our study, female gender, higher BMI and weight, decreased in financial income after outbreak, presence of diabetic complications and comorbid diseases (i.e., retinopathy, neuropathy, diabetic foot, hypertension, dyslipidemia), worsened glycemic levels, increased carbohydrate consumption, and snacking were associated with higher anxiety and depression scores. Depression was higher in patients with T2D and duration of illness was correlated with acute stress level.

Conclusions

It is important to be aware of the possibility of acute stress, depression, and anxiety after pandemic in patients with DM whose glycemic control is impaired. Psychological problems should not be ignored beyond physical inactivity and worsening eating habits.

中文翻译：

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COVID-19 爆发如何影响糖尿病患者？

背景

对大多数人来说，全球 COVID-19 爆发一直是一次压力很大的经历。使用基于网络的横断面研究，我们旨在评估 COVID-19 大流行期间糖尿病 (DM) 患者的急性应激反应、抑郁和焦虑，并检查这些精神问题对饮食习惯的影响和患者的血糖控制。

方法

这项基于网络的 COVID-19 调查通过 Whatsapp 平台发送给患者。所有参与者都报告了他们的人口统计数据、糖尿病相关信息、自我监测血糖测量值的变化、身体参数和 COVID-19 后的饮食习惯，然后完成了修订后的医院焦虑和抑郁量表 (HADS) 和事件量表的影响(IES-R) 问卷，用于评估急性压力症状、焦虑和抑郁。

结果

304 名 DM 患者 [（141 名 1 型 DM（T1D）和 163 名 2 型（T2D）] 被纳入研究。在我们的研究中，女性，较高的 BMI 和体重，暴发后经济收入下降，存在糖尿病并发症和合并症（即视网膜病变、神经病变、糖尿病足、高血压、血脂异常）、血糖水平恶化、碳水化合物消耗增加和吃零食与更高的焦虑和抑郁评分相关。2型糖尿病患者的抑郁程度更高，持续时间更长疾病与急性应激水平相关。

结论

重要的是要意识到大流行后血糖控制受损的 DM 患者可能出现急性压力、抑郁和焦虑。除了缺乏运动和饮食习惯恶化之外，不应忽视心理问题。